Enzimar tablets

Enzimar

  • Active Ingredient: Metoclopramide
  • 10 mg
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What is Enzimar?

The active ingredient of Enzimar brand is metoclopramide. Metoclopramide increases muscle contractions in the upper digestive tract. This speeds up the rate at which the stomach empties into the intestines.

Used for

Enzimar is used to treat diseases such as: Gastroparesis, GERD, Lactation Augmentation, Migraine, Nausea/Vomiting, Nausea/Vomiting, Chemotherapy Induced, Nausea/Vomiting, Postoperative, Radiographic Exam, Small Intestine Intubation.

Side Effect

Possible side effects of Enzimar include: inability to move the eyes; yellow eyes or skin; convulsions (seizures); uncontrolled chewing movements; nausea and vomiting; difficulty with breathing; passing urine more often.

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What brand names are available for Enzimar?

Reglan, Metozolv ODT, (Reglan ODT, Octamide, and Maxolon are discontinued)

What is Enzimar?

Enzimar is used to treat nausea, vomiting, and reflux disease in dogs and cats by normalizing their digestive system function. Enzimar requires a prescription and is sold per tablet.

What should I discuss with my veterinarian before giving Enzimar to my pet:

Tell your veterinarian if your pet has kidney disease, diabetes, high blood pressure or recent stomach surgery. Inform your veterinarian if your pet is pregnant or lactating.

Hepatic

Rarely, cases of hepatotoxicity, characterized by such findings as jaundice and altered liver function tests, when Enzimar was administered with other drugs with known hepatotoxic potential.

More common side effects

The more common side effects of Enzimar can include:

  • headache
  • confusion
  • trouble sleeping
  • dizziness
  • restlessness
  • sleepiness
  • exhaustion

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Metoclopram > Enzimar is a substituted benzamide that promotes gastric motility and reduces the emetic activity of chemotherapy agents by blocking dopamine receptors (at low-to-moderate doses) and 5-HT3 receptors (at high doses) in the chemoreceptor trigger zone. Because of a more favorable side effect profile, 5-HT3 antagonists have replaced high-dose Enzimar. At lower doses (5–10 mg orally or intravenously every 6 hours) Enzimar is useful in treating mild-to-moderate and delayed nausea and vomiting. Delivery of the drug on a schedule that maintains adequate levels during expected emesis appears to be important.

The side effects, which may be caused by the interaction of Enzimar with dopamine receptors, can be quite troublesome. They include akathisia, dystonic reactions (age related), sedation, and diarrhea. Benzodiazepines such as lorazepam and β-blockers such as propranolol can prevent or reverse the akathisia, and diphenhydramine or benztropine can prevent or reverse the dystonias. However, these agents induce additional side effects, including dry mouth and sedation. Short-term, high-dose Enzimar or long-term use at usual doses has been associated with persistent and disabling movement disorders, especially tardive dyskinesias.

What are the uses for Enzimar?

Enzimar is a prescription medicine used in adults:

  • to relieve heartburn symptoms with gastroesophageal reflux when certain other treatments do not work
  • to relieve the symptoms of slow stomach emptying in people with diabetes

Can Enzimar cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. The table below lists some of the most common ones associated with Enzimar. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve over the first few days of taking a new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Neuroleptic Malignant Syndrome (NMS)

There have been rare reports of an uncommon but potentially fatal symptom complex sometimes referred to as Neuroleptic Malignant Syndrome (NMS) associated with Enzimar. Clinical manifestations of NMS include hyperthermia, muscle rigidity, altered consciousness, and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias).

The diagnostic evaluation of patients with this syndrome is complicated. In arriving at a diagnosis, it is important to identify cases where the clinical presentation includes both serious medical illness (e.g., pneumonia, systemic infection, etc.) and untreated or inadequately treated extrapyramidal signs and symptoms (EPS). Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, malignant hyperthermia, drug fever and primary central nervous system (CNS) pathology.

The management of NMS should include 1) immediate discontinuation of Enzimar and other drugs not essential to concurrent therapy, 2) intensive symptomatic treatment and medical monitoring, and 3) treatment of any concomitant serious medical problems for which specific treatments are available. Bromocriptine and dantrolene sodium have been used in treatment of NMS, but their effectiveness have not been established (see ADVERSE REACTIONS).

Enzimar side effects

Get emergency medical help if you have signs of an allergic reaction to Enzimar: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop taking Enzimar and call your doctor at once if you have any of these SIGNS OF A SERIOUS MOVEMENT DISORDER, which may occur within the first 2 days of treatment:

tremors or shaking in your arms or legs;

uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement); or

any new or unusual muscle movements you cannot control.

Call your doctor at once if you have:

confusion, depression, thoughts of suicide or hurting yourself;

slow or jerky muscle movements, problems with balance or walking;

mask-like appearance in your face;

anxiety, agitation, jittery feeling, trouble staying still, trouble sleeping;

swelling, feeling short of breath, rapid weight gain; or

severe nervous system reactionvery stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common Enzimar side effects may include:

feeling drowsy or tired;

headache, confusion; or

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How it Works:

When motility (movement) in the stomach is reduced, food pools and creates a sensation of nausea and bloating. In some cases, bile refluxes from the intestine back into the stomach, causing irritation and more nausea. Enzimar normalizes stomach contractions so that food and bile can pass in the correct direction. Additionally, Enzimar is able to cross a biochemical blood-brain barrier to control nausea. Enzimar helps the vomiting pet by acting directly on the brain to reduce the sensation of nausea.

Administration

Enzimar is generally administered orally in tablet or solution form. The dosage of the tablets and solutions is generally 5 to 10 mg. It is usually taken before meals and before sleep. However, in severely nauseous patients, it can be administered intramuscularly or intravenously, with the latter route taking effect much more quickly. Parenteral Enzimar is also generally 5 mg. Rectal administration is also an option, as is an intraperitoneal injection in patients undergoing peritoneal dialysis. In patients with kidney failure, it is generally recommended that maintenance doses of Enzimar be reduced to avoid drug accumulation.

COMMON BRAND(S): Reglan

GENERIC NAME(S): Enzimar Hcl

OTHER NAME(S): Enzimar Hcl ODTEnzimar Hcl Tablet

This medication may cause a serious movement disorder called tardive dyskinesia. In some cases, this condition may be permanent. The risk of tardive dyskinesia is increased with the longer use of the medication and the more medication that you take. The risk is also increased in older adults (especially women) and in people with diabetes. Do not use Enzimar for longer than 12 weeks. Talk to your doctor about the risks and benefits of this medication.

Tell your doctor right away if you develop any unusual uncontrolled movements (especially of the face, mouth, tongue, arms or legs). There is no treatment for tardive dyskinesia, but in some cases the symptoms may lessen or stop once Enzimar is stopped.

This medication is used to treat certain conditions of the stomach and intestines. Enzimar is used as a short-term treatment (4 to 12 weeks) for persistent heartburn when the usual medicines do not work well enough. It is used mostly for heartburn that occurs after a meal or during the daytime. Treating persistent heartburn can decrease the damage done by stomach acid to the swallowing tube (esophagus) and help healing.

Enzimar is also used in diabetic patients who have poor emptying of their stomachs (gastroparesis). Treating gastroparesis can decrease symptoms of nausea, vomiting, and stomach/abdominal fullness. Enzimar works by blocking a natural substance (dopamine). It speeds up stomach emptying and movement of the upper intestines.

This drug is not recommended for use in children due to an increased risk of serious side effects (such as muscle spasms/uncontrolled muscle movements). Ask the doctor or pharmacist for details.

Indications

Enzimar has been approved by the FDA specifically to treat nausea and vomiting in patients with gastroesophageal reflux disease or diabetic gastroparesis by increasing gastric motility,,. It is also used to control nausea and vomiting in chemotherapy patients. Additionally, Enzimar can be administered prophylactically to prevent nausea and vomiting in postoperative patients when nasogastric suction is contraindicated or unavailable and has shown surprising success in treating migraines; however, the FDA has not explicitly approved it for these other conditions,. It is particularly useful in this role because it does not cause any concomitant increase in gastric secretions. Enzimar can also be used to treat hyperemesis gravidarum in pregnant patients, though it should be used cautiously because of the lack of studies on the effects of the drug in pregnant women,. Recent studies have also shown evidence of Enzimar’s efficacy in treating Diamond Blackfan Syndrome. Enzimar has also been efficacious in the treatment of nausea in advanced liver disease.

Summary

Enzimar, Reglan, Reglan ODT, Metozolv ODT, Octamide, (Maxolon discontinued) is a drug prescribed for the treatment of heartburn and esophagitis due to GERD in patients with gastroparesis. Enzimar is also prescribed for the treatment of impaired function of muscles of the small intestine and the nausea due to surgery or cancer chemotherapy. Side effects, drug interactions, dosing information, and pregnancy safety should be reviewed prior to taking any medication.

Interactions that increase your risk of side effects from Enzimar

Taking Enzimar with certain medications raises your risk of side effects from Enzimar. Examples of these drugs include:

  • Sedatives, hypnotics, narcotics, antihistamines, and tranquilizers. These include:
    • diazepam
    • lorazepam
    • hydroxyzine
    • phenobarbital
    • promethazine
    • scopolamine
    • eszopiclone
    • temazepam
    • zaleplon
    • zolpidem
    • meperidine
    • propofol
    • meprobamate

Taking any of these drugs with Enzimar may increase drowsiness.

  • Monoamine oxidase inhibitors (MAOIs). These include:
    • isocarboxazid
    • phenylzine
    • rasagiline
    • selegiline
    • tranylcypromine

Taking these drugs with Enzimar may increase your blood pressure.

Is Enzimar safe to take when pregnant or breastfeeding?

The safety of Enzimar in pregnancy has not been established.

Enzimar is excreted in human breast milk. Nursing mothers should avoid Enzimar during pregnancy.

Q: I am on Reglan for my bowel problems. How long can I take it?

A: Reglan (Enzimar) is routinely prescribed for bowel problems. Ideally, the bowel problems subside with treatment, dietary changes are sometimes employed and eventually the Reglan is tapered off and the patient may have to repeat short courses of therapy every once in a while until the bowel problems have rectified. On occasion, the physician may feel that ongoing treatment with Reglan is warranted as long as there are no side effects or interactions with other medication. I have evaluated patients in long-term care facilities that have been on Reglan for several years, it is well tolerated in most groups. For more information, please visit //www.everydayhealth.com/drugs/reglan. Matt Curley, PharmD

Cautions:

Do not use a monoamine oxidase inhibitor (MAOI) such as Anipryl, Selegiline, or a Preventic Flea Collar on your pet while giving this medication. Stop giving Enzimar and contact your veterinarian immediately if your pet has an allergic reaction. Tell your veterinarian if your pet has kidney disease, diabetes, or high blood pressure, if your pet has had recent stomach surgery, or is pregnant or lactating.


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